What kind of doctor should i see for eye allergies

Q: For the past day or two, my left eye has been watery, itchy and slightly painful. I am a contact lens wearer. So when I took my lens out, it seemed love my eye started to itch and water even more. — S.B.

Watch this video on tips for dealing with allergy eyes if you wear contacts.

My eyes aren't pink or red. They don't own thick mucus, love in pink eye (which I've had in the past). But I don't ponder it's allergies either, because there is pain in my eye when I use drops, wipe my eye or flush out my eye with water.

Also, these symptoms will stop for 10 minutes or so, and then they flare up again. — R.D., Georgia

A: Contact lens wearers experiencing eye pain without improvement should seek an eye doctor's evaluation correct away. There are several possible causes, including a corneal infection that could become sight-threatening if not diagnosed and treated rapidly.

What helpful of doctor should i see for eye allergies

Please do not delay in seeking proper care. — Dr. Chou

Q: A year ago, I started wearing contacts again. But this didn't final endless, because I started having problems with my left eye. I ran out of the solution my doctor gave me to use with the contacts. I had an older, unopened bottle of saline solution that I used instead. That's when I immediately started having problems with the left eye.

A diverse eye doctor I saw said I had

conjunctivitis

Priya Raja’s eyes were not cooperating.

A recent college graduate, she had struggled for months with on-and-off watery, red eyes and sensitivity to light.

She found it hard to glance at a computer screen at the medical startup where she worked in Cambridge, Mass., or to focus on the words on a page.

Thinking the symptoms might be due to conjunctivitis, a bacterial infection, her primary care doctor prescribed an antibiotic eye ointment. But Raja’s symptoms didn’t improve.

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“I worked from home because I couldn’t handle the lights in the office, I wore an eye patch, and I had to invert the colors on my phone because it was too hard to glance at the light,” said Raja, who is now “And my eyes were still constantly watering.”

She wasn’t too worried, though, since after each spell of symptoms, her eyes would go back to normal.

Raja figured it was just allergies; she otherwise felt well, without major medical problems, and she didn’t smoke or use drugs.

By November , however, her left eye had taken a turn for the worse; she woke one morning to discover it swollen shut. She was visiting family in Texas, and her mom took one glance at her and told her she was going to an eye doctor — stat. That’s when Raja met Julie Ngo, an optometrist in a group practice just exterior of Houston.


Symptoms Of Eye Allergies

Q: I believe I own really bad allergies.

I get extremely itchy eyes where I can't even touch them, because this makes the symptoms 10 times worse. I also own a runny nose and watering eyes. Do you ponder I should go see an eye doctor? Or is there something I can take for it?

What helpful of doctor should i see for eye allergies

— B.J.

A: Based on these symptoms, it is definitely a excellent thought to see an eye doctor. While your symptoms propose an allergic reaction from some environmental irritant, it is significant that an eye doctor law out less common causes such as parasitic infestation of the eyelids. Proper diagnosis will provide you with the best, most cost-effective treatment, which may range from over-the-counter allergy drops to prescriptive medicine. — Dr.

What helpful of doctor should i see for eye allergies

Chou

Q: I started using a new mascara about a week ago. Four days ago, I started to get itchy, red eyes, along with dry eyes and irritation. I also own been using gentamicin eye drops given to me as an antibiotic. Am I having an allergic reaction? Could it be an infection of some kind? Is it just a coincidence that this happened when I started using a new product? My eyes are extremely itchy, and the vessels are slightly enlarged — S.B.

A: You are correct that you may own an allergic reaction to the mascara and/or the gentamicin drops.

What helpful of doctor should i see for eye allergies

Gentamicin is an antibiotic prescribed for treating bacterial eye infections. Some patients are allergic to gentamicin. You should definitely consult your doctor who prescribed the gentamicin.

If you still own a bacterial eye infection, you may be prescribed a new antibiotic to replace the gentamicin. Treatment of allergy involves removing the offending agent and facilitating recovery, often with allergy medicine. — Dr.

What helpful of doctor should i see for eye allergies

Chou

Q: I own type 2 diabetes. What does having blurry, itchy, burning eyes mean? — L.M.

A: Without an examination, it is hard to know whether your symptoms are related to your diabetes. Schedule an appointment with your optometrist or ophthalmologist to make certain your symptoms do not indicate a serious, underlying problem. — Dr. Chou


Eye Allergy Symptoms: Q&A

Questions were answered by Brian Chou, OD

[Editor's note: Every About Vision receives numerous questions about eye allergies and related symptoms such as bloodshot eyes, eye redness and itching.

In this Q&A, Every About Vision board member Brian Chou, OD, answers questions about causes, treatments and common symptoms related to eye allergies.]


Eye Drops For Allergies

Q: I own itchy eyes and eyelids. I already use Refresh Tears eye drops. But I wonder if you could assist out with some other suggestions? — T.

A: Artificial tears, such as Refresh Tears (Allergan), are somewhat helpful for eye allergy because they dilute the concentration of irritant on the eye surface. However, artificial tears do not prevent the release of chemical substances that start the allergic reaction. In fact, the clinical studies evaluating prescriptive eye drops for allergy frequently use artificial tears as a

placebo

.

Avoiding the offending agents — commonly dust, pollen and pet dander — is the ideal preventative step.

However, it is not always possible to identify and avoid the causative agents (called

allergens

).

An over-the-counter antihistamine eye drop containing ketotifen (kee-toe-TIE-fen) can effectively manage numerous cases of common eye allergy. Ketotifen is marketed under several brands, including Zaditor OTC (Novartis), Alaway (Bausch + Lomb), Zyrtec Itchy Eye Drops (McNeil Consumer Healthcare) and Claritin Eye Allergy Relief (Schering-Plough).

For numerous patients, however, prescriptive allergy eye drops are most effective and potentially more cost-effective than over-the-counter treatments.

As an example, clinical studies own shown that olopatadine hydrochloride (Pataday/Patanol, Alcon) eye drops produce better results and are better tolerated when compared with ketotifen.

Your best bet is to own an eye examination to discover out what is best for you. — Dr.

What helpful of doctor should i see for eye allergies

Chou

Q: I've had red, itchy eyes for months now. This generally occurs at night. No eye drops own helped me. In fact, I own used bottles and bottles of eye drops.

What helpful of doctor should i see for eye allergies

— K.

A: It is definitely time for you to seek professional assist. Excessive self-dosing of bottled, over-the-counter eye drops can make matters even worse, due to preservative toxicity. Every bottled eye drops must contain a preservative to prevent contamination. However, numerous of these preservatives — when in contact with the eye — can eventually cause chronic eye irritation. Please schedule an examination with an eye doctor. — Dr. Chou


Failed treatment leads to a diagnosis

Ngo started Raja on acyclovir — an antiviral medicine — and steroid and antibacterial eye drops.

These would both quell a possible infection and tamp below on eye inflammation. Raja’s response to these medicines would provide key insight into the cause of her problems.

For a few months, her eyes got better; after a few weeks, she had finished the course of acyclovir and antibiotics, then tapered off the steroid drops as directed to avoid long-term steroid use in the eye.

But just a few weeks later, the redness, watering, and light sensitivity returned. An ophthalmologist in Boston — where Raja was working at the time — again prescribed a few weeks of antibiotic and steroid eye drops, and again these medicines alleviated her symptoms.

Yet frustratingly, after a few months, her eyes worsened once more, and the vision in her left eye became blurry. Raja had just started medical school at the University of Texas, Southwestern, in Dallas, and she attributed the resurgence of her symptoms to exposure to acrid fumes in anatomy lab.

“My vision got so bad I was having a hard time driving, and I had to mega-zoom every the text on my computer screen,” Raja said.

That brought her back to Ngo’s office, where she was officially diagnosed with ocular rosacea based on the way her symptoms repeatedly flared after stopping the steroids. Ngo believes the toxic effects of bacterial overgrowth own also compounded the inflammation from Raja’s rosacea — a vicious cycle kept at bay by anti-inflammatory and antibiotic medicines.

In retrospect, the diagnosis of ocular rosacea also made sense because Raja and a family member likely own rosacea of the skin, sometimes known as acne rosacea; the two conditions tend to run in families and overlap.

About 60 to 70 percent of the 14 million people in the U.S. with acne rosacea also own eye involvement, and about one-fifth of the time, the disease affects the eyes first. Doctors don’t know what causes rosacea, although genetics and environmental triggers may frolic a role.


Taking a closer look

When examining the eyes, Ngo said in an interview, “we go from the exterior in, starting around the eyelid and eyelashes.”

Ngo (pronounced “No”) was immediately struck by Raja’s watery, red eyes and the fact that Raja could hardly pry open her left eye. “She looked extremely uncomfortable,” Ngo said.

Upon closer inspection, Ngo noted the film of tears that should smoothly cover the surface of the eye was patchy.

And some of the oil glands around Raja’s eye, known as Meibomian glands, were clogged. That was compounded by Raja’s thick, endless eyelashes, Ngo said.

“Long, luscious eyelashes aesthetically glance amazing, but they can hold a lot of debris,” she said. Love any hair, eyelashes can trap skin oils and dirt, providing the perfect environment for bacteria to grow.

Then Ngo examined Raja’s eyes under the microscope. Fluorescein dye — which binds to dead or dying cells on the surface of the eye — revealed a 2-millimeter open sore on the clear dome covering the left iris and pupil, called a corneal ulcer.

Other parts of the cornea had broken below, too, and additional blood vessels snaked through it.

What helpful of doctor should i see for eye allergies

These findings pointed to ongoing eye irritation.

“It looked love a smoldering, chronic sort of problem,” Ngo said. The cornea gets much of its oxygen from the atmosphere, but when it’s under a long-term attack, it sends out chemical mediators that beckon for more blood flow, Ngo said.

Given these findings, Ngo was surprised to study Raja didn’t wear contact lenses, which is a top risk factor for corneal ulcers. She dug deeper, considering other types of problems that could cause Raja’s included an infection by the herpes virus called herpes keratitis, and an overgrowth of staphylococcus bacteria.

Adult inclusion conjunctivitis, from the bacteria that cause chlamydia, was another possibility, but Raja’s symptoms and risk factors didn’t fit.

Another possibility was that Raja’s eye problems stemmed from inflammation, Ngo thought; this could explain why both eyes were affected. Ocular rosacea, a type of the condition better known for causing red skin on the face, might make sense. In addition, because Raja’s ulcer was near the eyelid — where bacteria tend to dwell, thanks to the eyelashes — Ngo wondered whether inflammation from a toxin produced by staphyloccus bacteria could be contributing.


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